Neonate with Bilious vomiting Medical Question:
A 10 hour old girl has bilious emesis. She was born at 34 weeks gestation by vaginal delivery to a 24 year old woman who did not receive any prenatal care and used cocaine during her pregnancy. The infant has not had a bowel movement but has urinated. She was able to take a 2 bottle feeds by mouth but has been vomiting since the third feed. Birth weight was 2 kg (4 lb 6 oz), small for gestational age. Respirations are 39/min, Pulse 145/min and temperature 98.4F. The abdomen is distended and the skin is loose with diffuse lanugo. The rest of the examination is unremarkable. Abdominal radiograph is show. Which of the following is most likely the diagnosis.
A- Cocaine withdrawal
B- Hirschsprung’s disease
C- Duodenal atresia
D- Necrotizing Enterocolitis
E- Jejunal atresia
F- Pyloric stenosis
Neonate with Bilious vomiting.
Reference: USMLE world, LLC, Qbank ver 2009.02
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